Stakeholder Stakeholder InvolvementInvolvement

Dunadry HotelDunadry Hotel

2121stst November 2007 November 2007

Stakeholder Stakeholder Involvement WorkshopInvolvement Workshop

Sean DonaghySean DonaghyDirector of Finance and Corporate Director of Finance and Corporate

Services (Designate)Services (Designate)Health and Social Care AuthorityHealth and Social Care Authority

Objectives for workshopObjectives for workshop

• To provide an update on progress since To provide an update on progress since the last workshop in Junethe last workshop in June

• To quality assure and comment on the To quality assure and comment on the final draft of the Stakeholder Involvement final draft of the Stakeholder Involvement Framework documentFramework document

• To seek a network response to Programme To seek a network response to Programme for Government, and to inform 2009/10 for Government, and to inform 2009/10 Health and Social Care prioritiesHealth and Social Care priorities– Through focussing today on a single key themeThrough focussing today on a single key theme

Why a Stakeholder Why a Stakeholder Involvement Network?Involvement Network?

• Demonstration of commitment to engagementDemonstration of commitment to engagement

• Enable views to be gathered in relation to relevant Enable views to be gathered in relation to relevant

mattersmatters

• Establish good practice in relation to engagement Establish good practice in relation to engagement

and partnershipand partnership

• Create a resource for network participants and for Create a resource for network participants and for

those involved in policy development, those involved in policy development,

commissioning and planning.commissioning and planning.

Recap from 21st June workshop

• broad support and enthusiasm for a broad support and enthusiasm for a regional network. regional network.

Network could add value by:Network could add value by:• systematic sharing of information and systematic sharing of information and

practice andpractice and• securing resolved views and advice from a securing resolved views and advice from a

diverse stakeholder group on regional diverse stakeholder group on regional challenges and opportunities to improve challenges and opportunities to improve health and wellbeing. health and wellbeing.

The network, The network, ““has the potential to be an effective has the potential to be an effective

influencer; we will look to it to reflect influencer; we will look to it to reflect the views and aspirations of the views and aspirations of stakeholders, so that Government stakeholders, so that Government priorities are rooted in the experience priorities are rooted in the experience of users and stakeholders”.of users and stakeholders”.

Andrew Hamilton, June 2007Andrew Hamilton, June 2007

Where are we now?Where are we now?• Framework documentFramework document

– Discussion over past two monthsDiscussion over past two months– ‘‘Positioning’ the network on a crowded pitchPositioning’ the network on a crowded pitch– Local Commissioning Group roleLocal Commissioning Group role– Trust roleTrust role

• ‘‘Virtual’ network for e-communicationVirtual’ network for e-communication– website in design and development stagewebsite in design and development stage– discussion forum discussion forum

••

Other issues in progressOther issues in progress

• Public Attitude Survey, follow up – Public Attitude Survey, follow up – qualitative workqualitative work

• Patient opinionPatient opinion• Guidelines for commissioners (CDHN)Guidelines for commissioners (CDHN)• Benefits realisation planBenefits realisation plan• Series of workshops on general and Series of workshops on general and

specific issuesspecific issues• Mapping exerciseMapping exercise• RCGPRCGP

ProgrammeProgramme

• Welcome backWelcome back

• Update and progress since June workshopUpdate and progress since June workshop

• Outline for todayOutline for today

• Session 1 – Draft Framework DocumentSession 1 – Draft Framework Document

• BreakBreak

• Session 2 – Informing PolicySession 2 – Informing Policy– Overview of policy and planning CycleOverview of policy and planning Cycle– Independent living themeIndependent living theme

• Direct paymentsDirect payments

• Tele-HealthTele-Health

• Supported HousingSupported Housing

Sharon HenrySharon Henry

Project Director Project Director

Stakeholder InvolvementStakeholder Involvement

Modernisation Directorate Modernisation Directorate

ProcessProcess

• Ongoing discussion over past two Ongoing discussion over past two monthsmonths

• Useful discussion and comment at Useful discussion and comment at formative stageformative stage

• These have been/will be incorporated These have been/will be incorporated into documentinto document

Draft Framework Draft Framework

AimAim• To create a process that brings together To create a process that brings together

stakeholders to work collectively to stakeholders to work collectively to improve health and wellbeing in Northern improve health and wellbeing in Northern Ireland by facilitating the exchange of Ireland by facilitating the exchange of knowledge, ideas and information to knowledge, ideas and information to inform and influence policy and actions inform and influence policy and actions through an open participative regional through an open participative regional network.network.

Objectives Objectives • To develop a network of stakeholders in To develop a network of stakeholders in

Northern Ireland linked to existing networks Northern Ireland linked to existing networks in order to create a regional system which in order to create a regional system which adds value to all who participate.adds value to all who participate.

• Develop mechanisms that enable the Develop mechanisms that enable the network to identify and prioritise regional network to identify and prioritise regional themes which can contribute to Programme themes which can contribute to Programme for Government and Priorities for Actionfor Government and Priorities for Action

• To become an effective influencer in To become an effective influencer in strategic decisions making and priorities, strategic decisions making and priorities, through informed collective responses.through informed collective responses.

DEPARTMENTPOLICIES

DEPARTMENTPOLICIES B

ALANCE

BALANCE

LOCAL STAKEHOLDER INVOLVEMENT

LOCAL STAKEHOLDER INVOLVEMENT

PROGRAMME FOR GOVERNMENT

PROGRAMME FOR GOVERNMENT

Northern IrelandASSEMBLY

Northern IrelandASSEMBLY

• HSC TRUSTSBELFAST

SOUTHERNSOUTH EASTERN

NORTHERNWESTERN

Ambulance Trust

• LCG’s• IfH

• HSC TRUSTSBELFAST

SOUTHERNSOUTH EASTERN

NORTHERNWESTERN

Ambulance Trust

• LCG’s• IfH

SERVICE

USERS

SERVICE

USERS

BOARDS/HSCA

BOARDS/HSCA

MEASURING & EVALUATING IMPACTMEASURING & EVALUATING IMPACT

Northern IrelandSTAKEHOLDERINVOLVEMENT

NETWORK

Northern IrelandSTAKEHOLDERINVOLVEMENT

NETWORK

COMMUNITIES OF INTEREST“THE ARTICULATE VOICE”

COMMUNITIES OF INTEREST“THE ARTICULATE VOICE”

STAKEHOLDER INVOLVEMENTIN

NORTHERN IRELANDInforming Policy – Improving Implementation

STAKEHOLDER INVOLVEMENTIN

NORTHERN IRELANDInforming Policy – Improving Implementation

&

WELL

BEING

POPULATION

HEALTH

The Network

Formal Management Arrangements

OTHER NGOs & STATUTORY

ORGANISATIONS

COMMUNITY & VOLUNTARY

ORGANISATIONS

OTHER NGOs & STATUTORY

ORGANISATIONS

COMMUNITY & VOLUNTARY

ORGANISATIONS

Questions for DiscussionQuestions for Discussion

1.1. Does the Framework document Does the Framework document clearly define the purpose of this clearly define the purpose of this network? (Section 4)network? (Section 4)

2.2. Does the Framework document Does the Framework document clarify how this network links with, clarify how this network links with, but is distinct from, other but is distinct from, other Stakeholder Involvement processes Stakeholder Involvement processes in HSC? in HSC?

(Section 5)(Section 5)

Questions (cont …)Questions (cont …)

3.3. Does the Framework document Does the Framework document demonstrate the added demonstrate the added value/benefits participants will get value/benefits participants will get from contributing to the network?from contributing to the network?(Sections 6 & 7)(Sections 6 & 7)

4.4. Any other comments/questions in Any other comments/questions in relation to the documentrelation to the document

Overview of Policy and Overview of Policy and Planning CyclePlanning Cycle

Sean DonaghySean Donaghy

Overview of Policy and Planning Cycle

Theme for informing Theme for informing response to Programme for response to Programme for Government and 2009/10 Government and 2009/10 PrioritiesPriorities

Independent LivingIndependent Living• Health and Social Care strategies and policy

• Draft Programme for Government

• Why hasn’t it happened already, how can we move from policy to practice?

Direct paymentsDirect payments

• Health and Social Care introduced schemes to Health and Social Care introduced schemes to allow individuals to control funds to meet their allow individuals to control funds to meet their care needs over 15 years agocare needs over 15 years ago

• Very low levels of take-upVery low levels of take-up• Vela Micro Boards in Southern areaVela Micro Boards in Southern area• Potential for enhancing choice and moving to Potential for enhancing choice and moving to

truly person-centred planningtruly person-centred planning• What about 1,000s of people with Chronic What about 1,000s of people with Chronic

Disease, Older People, in addition to current Disease, Older People, in addition to current limited progress in Physical and Learning limited progress in Physical and Learning Disability?Disability?

• How do we move to personal choice as the core How do we move to personal choice as the core approach? approach?

Anne LynchAnne Lynch

Regional Director of Regional Director of Commissioning (Designate)Commissioning (Designate)

Health and Social Care Health and Social Care AuthorityAuthority

Tele - HealthTele - Health

What is Tele-Health?What is Tele-Health?

• At its broadest definition…..At its broadest definition…..conducting conducting therapeutic health and/or care interactions therapeutic health and/or care interactions between patients/clients and health and between patients/clients and health and care professionals by supplementing any care professionals by supplementing any face to face contact with technological face to face contact with technological linkslinks

• Sometimes ‘tele-health’, ‘tele-care’, tele-Sometimes ‘tele-health’, ‘tele-care’, tele-diagnostics’, ‘tele-monitoring’ used almost diagnostics’, ‘tele-monitoring’ used almost interchangeablyinterchangeably

What is Tele-Monitoring?What is Tele-Monitoring?

• A number of people A number of people stay at home stay at home independentlyindependently

• Linked electronically Linked electronically to a central nurse to a central nurse led serviceled service

• Vital signs Vital signs transmitted daily by transmitted daily by patients/clients to patients/clients to nursing stationnursing station

The ImperativeThe Imperative

• Demography – working age population to Demography – working age population to grow by 8% by 2019grow by 8% by 2019

• Over 65 years population to grow by 35% Over 65 years population to grow by 35% by 2019by 2019

• More single person householdsMore single person households• Chronic diseases will increaseChronic diseases will increase• Many people currently in and out of Many people currently in and out of

hospital frequently when they could be hospital frequently when they could be supported more appropriately elsewheresupported more appropriately elsewhere

Chronic DiseasesChronic Diseases

• Heart FailureHeart Failure

• Respiratory diseasesRespiratory diseases

• DiabetesDiabetes

• StrokeStroke

• Physical DisabilityPhysical Disability

• CancerCancer

Who could benefit?Who could benefit?

• Patient selection is keyPatient selection is key

• Used in conjunction with traditional Used in conjunction with traditional home carehome care

• Provided 7 days a weekProvided 7 days a week

• Customised reports sent to GPs etc.Customised reports sent to GPs etc.

What is needed at home?What is needed at home?

• The electronic kit as shownThe electronic kit as shown

• Working phone lineWorking phone line

• Home is safe for the equipmentHome is safe for the equipment

• Person can perform monitoring by 12 Person can perform monitoring by 12 noonnoon

Equipment in the Equipment in the patients homepatients home

How does it work on a daily How does it work on a daily basis?basis?

• Patient/client uses his/her home based Patient/client uses his/her home based technology to monitor vital signstechnology to monitor vital signs

• Device also asks disease specific Device also asks disease specific questionsquestions

• Patient transmits information to central Patient transmits information to central Nursing StationNursing Station

• Nurse monitors information and evaluates Nurse monitors information and evaluates anything outside normal parametersanything outside normal parameters

• Nurse contacts patient, District Nurse, GP Nurse contacts patient, District Nurse, GP etc as appropriate etc as appropriate

Dashboard: shows daily readings of patient specific information

BenefitsBenefits

• Supports people in their own homesSupports people in their own homes

• Reduces hospital acquired infection Reduces hospital acquired infection riskrisk

• Develops expert patientsDevelops expert patients

• Health improvement benefits for the Health improvement benefits for the family circlefamily circle

• Potential for community capacity Potential for community capacity developmentdevelopment

• Decreases frequency of nursing visits Decreases frequency of nursing visits but makes them more appropriate but makes them more appropriate and targetedand targeted

• Specialist nurses/others can be sent Specialist nurses/others can be sent to homes where necessaryto homes where necessary

• Better planning for the case load of Better planning for the case load of people in a local areapeople in a local area

Promoting Promoting IndependenceIndependencebyby

Supported HousingSupported Housing

Basic AssumptionsBasic Assumptions

• People would prefer to live ‘in their People would prefer to live ‘in their own home’ for as long as possibleown home’ for as long as possible

• In principle, people should have that In principle, people should have that right. right.

• What (if anything), in terms of health What (if anything), in terms of health and care dependency, might limit and care dependency, might limit people in exercising such a right?people in exercising such a right?

• What can reasonably be done by What can reasonably be done by Government, to promote it?Government, to promote it?

Current Supportive Current Supportive PoliciesPolicies• Appropriately designed new build housingAppropriately designed new build housing• Housing adaptationsHousing adaptations• Sheltered HousingSheltered Housing• ‘‘Housing with Care’Housing with Care’• ‘‘People First’People First’• ‘‘Supporting People’Supporting People’• ‘‘Floating Support’Floating Support’• ‘‘Community Safety’Community Safety’

Considerations for Policy-Considerations for Policy-makersmakers

• Real joint planning of Housing and Care Real joint planning of Housing and Care budgets – not just aligned policiesbudgets – not just aligned policies

• Ensuring that Government Departments Ensuring that Government Departments really agree the level of dependency of really agree the level of dependency of people who can be maintained at home people who can be maintained at home

• Planning for population need or Planning for population need or responding to market forcesresponding to market forces

Considerations for Planning Considerations for Planning SchemesSchemes

• Combination of independence and Combination of independence and safetysafety

• Entry criteria for residentsEntry criteria for residents

• Size of schemes – influence on range Size of schemes – influence on range of facilities that can be providedof facilities that can be provided

• The importance of location and design The importance of location and design features of individual dwellingsfeatures of individual dwellings

• The ‘housing’ element of ‘Supported The ‘housing’ element of ‘Supported Housing’ is not a secondary consideration Housing’ is not a secondary consideration for residentsfor residents

• Informal support from family and Informal support from family and volunteers is integral to functioningvolunteers is integral to functioning

Connecting with real Connecting with real experienceexperienceYou are having lunch with a colleague from another You are having lunch with a colleague from another

organisation who is planning to set up a service organisation who is planning to set up a service incorporating Telehealth/Direct Payments/Supported incorporating Telehealth/Direct Payments/Supported Housing/Other. Describe an incident or event from Housing/Other. Describe an incident or event from your own or others’ experience or evidence from your own or others’ experience or evidence from research with which you are familiar which would research with which you are familiar which would illustrate to him/ her what it takes to put this in illustrate to him/ her what it takes to put this in place in a way which truly promotes independent place in a way which truly promotes independent living for the service users?living for the service users?

Have you an example from your experience on how Have you an example from your experience on how NOT to go about it?NOT to go about it?

The stories/incidents must be real i.e. describing The stories/incidents must be real i.e. describing something that actually happenedsomething that actually happened

Informing PolicyInforming Policy• In the light of your earlier conversations In the light of your earlier conversations

and the themes which emerged, what three and the themes which emerged, what three suggestions should be factored into suggestions should be factored into government policy in regard to:government policy in regard to:

Telehealth/Direct Payments/Supported Telehealth/Direct Payments/Supported Housing/OtherHousing/Other

which would help people live independently which would help people live independently with maximum autonomy in the areas which with maximum autonomy in the areas which they can exercise control?they can exercise control?

• Have you any further comments or Have you any further comments or questions for the plenary session?questions for the plenary session?

Almost thereAlmost there• Please complete evaluation forms and return.Please complete evaluation forms and return.

• Provisional date for next event 20Provisional date for next event 20thth March March

20082008

• Presentations available on webPresentations available on web

• Please return name badges for recyclingPlease return name badges for recycling

• Lunch and opportunity for networkingLunch and opportunity for networking

• Thank you for coming!Thank you for coming!

Any further comments Any further comments

email toemail to

stakeholderengagement@dhsspsni.govstakeholderengagement@dhsspsni.gov.uk.uk